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Led by the Treasure Coast Unitarian Universalist Congregation music director Jackie May (from left); Carolyn Haykin, of Jensen Beach; Stuart commissioner Eula Clarke; Barney Miller Moore, of Port St. Lucie; and Fred Fiske, seasonal resident of Stuart, join hands and sing "We Shall Overcome" on Monday, Jan. 15, 2018, at East Stuart Partnership's Martin Luther King Jr. celebration at Memorial Park in Stuart. Out of Florida's 67 counties, Martin ranked as the third healthiest in the state, inching up two spots from 2017. Indian River and St. Lucie counties ranked 21 and 22, respectively, with St. Lucie jumping eight spots and Indian River dropping just slightly. Some of the areas graded were healthy behaviors, clinical care and quality of life.(Photo: LEAH VOSS/TCPALM)Buy Photo

Martin remains one of the healthiest counties in Florida, according to an annual study that ranks nearly every county in the United States.

The 2018 County Health Rankings, issued by the University of Wisconsin and the Robert Wood Johnson Foundation, looks at more than 30 factors, such as medical care, education, housing, jobs and transportation, that influence how long and how well people live. In Florida, much of the data used is gathered from the Community Health Assessment Resource Tool Set.

Out of Florida's 67 counties, Martin ranked third, climbing two spots from 2017. Indian River and St. Lucie counties ranked 21 and 22, respectively, with St. Lucie jumping eight spots and Indian River dropping slightly.

Statewide, St. Johns County is the healthiest and Union County is the least healthy.

The Florida Department of Health released the 2018 County Health Rankings & Roadmaps on March 14 and Martin County ranked third, Indian River County ranked 21st and St. Lucie County ranked 22nd in overall health.(Photo: CONTRIBUTED PHOTO FROM THE FLORIDA DEPARTMENT OF HEALTH)

Martin County

Martin shined in most categories.

It ranked third for "quality of life," which evaluates factors such as how many sick and mental health days workers take off and the percentage of babies with low birth weight. Martin also performed well for "length of life," ranking 11th.

Martin also scored high, ranking seventh, in "health behaviors," which calculates factors such as obesity, smoking, access to exercise opportunities and teen births.

It rated high (11th) in "social and economic factors," especially for its high school graduation rates (89 percent) and violent crime (232 compared to the state average of 500).

Karlette Peck, health officer at the Florida Department of Health in Martin County, said the high health scores are a result of community partnerships.

"People work together," she said. "Because of that, we're able to accomplish quite a bit more than if we were all going in different directions.

"All the quality of life indicators are lower, which is a good thing."

County initiatives also have lowered teen drinking, childhood obesity and poverty rates in children.

Peck credits the success of the 5210 Plan — five servings of fruits and vegetables a day; two recreational hours of screen time; one hour of vigorous exercise; and zero sugary beverages — for the reduction in child obesity rates. The school-based Oral Health Prevention program, which is funded in part by the Children's Services Council of Martin County, also generated positive changes, serving more than 3,800 children since in began in late 2014.

"If everyone's speaking the the same voice and promoting the same message, that's how change is made in the community," Peck said.

Martin did see an increase in two negative "health behaviors," alcohol-impaired driving deaths and excessive drinking. The state average of alcohol-involved driving deaths is 26 percent, but Martin's is 35. The percentage of adults reporting binge or heavy drinking is 20 percent in Martin vs. 18 percent statewide.

One way to battle those behaviors, Peck said, is continued education and enforcement.

"We'd treat it just like any behavior change," she said. "It involves the whole community."

Under "clinical care," which assesses the ratio of health care providers to residents, Martin County ranked sixth in the state, even though there was one surprising result, according to Peck.

The ratio of the population to primary physicians is a bit higher in Martin, 1,420 to one, compared to the state average of 1,380 to one.

One reason could be many physicians decide to study a specialty, Peck said, and it sometimes is difficult to attract primary physicians to rural areas like Indiantown.

In 2013, Florida became one of the first states to implement the Community Health Improvement Plan (CHIP), which is available in all 67 counties. It defines a vision and creates a road map for improving the health of the community and is developed in collaboration with local governments, nonprofit organizations, health care professionals, business groups, schools and faith-based organizations.

In 2016-2020, three focus areas were identified for improvement in Martin County: education and awareness of existing health and human services; improving school health services; and reducing obesity rates.

"We still see a disparity in obesity rates between the western and eastern parts of the county," Peck said. "We're working countywide, but we have dedicated funding to a healthy weight nurse who focuses on Indiantown.

"Martin County has a very strong desire to do a good job raising our children to be healthy," Peck said. "We're very fortunate."

The overall rankings in health factors represent what influences the health of a county. All three Treasure Coast counties dropped slightly from 2017. Martin County is ranked fourth (third in 2017); Indian River County is ranked 22nd (17th in 2017); and St. Lucie County is ranked 35th (31st in 2017).(Photo: CONTRIBUTED PHOTO FROM THE FLORIDA DEPARTMENT OF HEALTH)

Indian River County

Even though the county slipped a bit in the rankings, it did improve in key areas, including alcohol-impaired driving deaths, teen births, unemployment and child poverty, said Stacy Brock, spokeswoman for the Florida Department of Health in Indian River.

Those improvements demonstrate why community partnerships are critical, Brock said.

"(The rankings) helps us to see where we need to shed light on some of the obstacles and identify how to improve and where we can improve," she said.

Like in Martin, Brock said Indian River County's CHIP is instrumental to improving the lives of its residents.

"Working with our community partners is a great way to get together and keep improving," she said.

Andrea Berry, CEO of the Indian River Healthy Start Coaltion, leads the CHIP infant mortality work group.

"It is inspiring to sit in a room that is representative of the diversity of our community and set meaningful goals towards lowering infant mortality and morbidity rates in our county," Berry said in a news release.

Indian River's best performance (third) came in "physical environment," which assesses things like air pollution, long commutes to work and and severe housing problems.

Like Martin and St. Lucie counties, Indian River also improved greatly this year in the percentage of residents younger than 65 without insurance, improving to 19 percent from 23 percent. It ranked 15th statewide in the "clinical care" category.

St. Lucie County

In St. Lucie County, the biggest gain came in "quality of life." It ranked 22nd, jumping 25 spots from 47th. The percentage of residents younger than 65 without insurance improved, too, from 21 percent to 18 percent.

The county also saw gains in "health behaviors," including slight decreases in the adult obesity rate and alcohol-impaired driving deaths. The teen birth rate also declined, according to the report, going from 33 to 26.

Clint Sperber, administrator for the Florida Department of Health in St. Lucie County, said decreases in the county's unemployment and violent crime rates and increases in the graduation rate also show that county programs focused on those areas are working.

"Those impacts definitely caught our eye," he said. "Knowing how well the school district has been performing over the past several years, we should see the trend continue in our favor."

Continuing to work with its partners, Sperber said, is key to insuring residents remain healthy.

"We are always looking to improve," he said. "And it takes an entire community to address public health issues. It involves everyone if we really want to have a collective impact and make change."

There are several initiatives already in place, Sperber said, that have helped the county make gains.

The 2018 Billion Step Challenge increases physical activity to reduce obesity. Baby Steps, Baby Friendly is an initiative that aims to increase breast-feeding among new mothers, and Safe Kids St. Lucie County focuses on reducing unintentional injuries to children with an emphasis on car seat safety and drowning prevention.

The county's strategic improvement plan for CHIP, revised about every three years, also will be updated later this year, Sperber said. The group will examine hard data and figure out what health issues are top priority.

Maureen Kenyon is TCPalm's trends reporter, keeping Treasure Coast residents updated on hot topics and happenings. Do you have a story to tell? Want to start a conversation? Send an email to maureen.kenyon@tcpalm.com, call 772-221-4249 or follow her on Twitter @_MaureenKenyon_.